Research progress of drug-withdrawal in patients after epilepsy surgery
10.3969/j.issn.1002-0152.2023.12.009
- VernacularTitle:癫痫患者手术后撤药研究进展
- Author:
Xiaying GU
1
;
Lu YANG
;
Qing DI
Author Information
1. 南京医科大学附属脑科医院神经内科(南京 210029)
- Keywords:
Epilepsy surgery;
Drug-resistant epilepsy;
Anti-seizure medications;
Drug-withdrawal;
Relapse;
Prognosis;
Risk factors
- From:
Chinese Journal of Nervous and Mental Diseases
2023;49(12):753-757
- CountryChina
- Language:Chinese
-
Abstract:
Epilepsy surgery is an effective treatment of drug-resistant epilepsy.Once patients became seizure free for certain period after epilepsy surgery,whether anti-seizure medications(ASMs)could be withdrawn is the primary concern of clinicians and patients.However,there is no consensus about management of anti-seizure medications in patients after epilepsy surgery.Patients after epilepsy surgery can withdraw ASMs when they become seizure free for 1 to 2 years.The dose reduction is usually done at every 2 to 3 months.For patients receiving multiple ASMs,each one should be individually tapered completely prior to the subsequent medication and the primary medication is always withdrawn in the end.Longer epilepsy duration prior to surgery,older age at surgery,patients with focal cortical dysplasia,incomplete resection of the epileptogenic zone and presence of interictal epileptiform discharges in postoperative EEG may predict the risk of seizure relapse in patients who underwent ASM withdrawal after epilepsy surgery.Patients with seizure relapse on ASM withdrawal generally have benign outcome after reinstitution of medical treatment.
